miércoles, 27 de enero de 2016

The
Salmonella Poona outbreak first disclosed to the public last
Sept. 4,
and since found to be caused by imported Mexican cucumbers has now rolled into
the new year with up to two additional deaths and 50 more cases in 16 states
since the last report from the federal Centers for Disease Control and
Prevention in Atlanta. CDC Tuesday issued its first update on the deadly outbreak
since last Nov. 19, saying 888 illnesses and six deaths are now
associated with the Salmonella Poona outbreak in 39 states. The dangerous
outbreak has sent 191 to local hospitals for care. And 106 illnesses have
occurred since the recalled cucumbers should have no longer been available in
grocery stores or restaurants.

This
is the same outbreak where the Food and Drug Administration (FDA) traceback
investigation ended up at the Rancho Don Juanito de R.L. de C.V. located in
Baja, Mexico as the source of the contaminated cucumbers that were then shipped
into the United States via a San Diego produce distributor.

To
correct the apparent violation, Rancho Don Juanito de R.L. de C.V. was told it
needs to demonstrate it has identified the potential sources and routes of
contamination and have taken steps to prevent future contamination before the
company’s cucumbers can be removed from the Import Alert.

Six
deaths have been reported from Arizona (1), California (3), Oklahoma (1), and
Texas (1). However, the California Department of Public Health, says Salmonella
infection was considered to be a contributing factor in only one of the three
deaths in California.

The
company further reports that these cucumbers are shipped in a black, green,
yellow, and craft colored carton which reads “Limited Edition Pole Grown
Cucumbers.” This variety is often referred to as a “Slicer” or “American”
cucumber. It has a dark green color. It typically has a length of 7
to 10 inches and a diameter of 1.75 to 2.5 inches. In retail it is
typically sold in a bulk display without any individual packaging or plastic wrapping.
In food service it is typically served as part of a salad.

lunes, 25 de enero de 2016

Vegetables were produced at
Springfield, Ohio Dole Processing Facility.

Epidemiologic
and laboratory evidence available at this time indicates that packaged salads
produced at the Dole processing facility in Springfield, Ohio and sold under
various brand names are the likely source of this outbreak.

State
and local health departments are interviewing ill people about the foods they
may have eaten or other exposures in the month before their illness began. Of
five ill people who were asked about packaged salad, all five (100%) reported
eating a packaged salad. Two (100%) of two ill people who specified the brand
of packaged salad eaten reported various varieties of Dole brand packaged
salad.

Twelve
people infected with the outbreak strain of Listeria
have been reported from six states since July 5, 2015. The number
of ill people reported from each state is as follows: Indiana (1),
Massachusetts (1), Michigan (4), New Jersey (1), New York (4), and Pennsylvania
(1). WGS has been performed on clinical isolates from all 12 ill people and has
shown that the isolates are highly related genetically.

As
part of a routine product-sampling program, the Ohio Department of Agriculture
collected a Dole brand Field Greens packaged salad from a retail location and
isolated Listeria. This packaged salad was produced at the Springfield,
Ohio Dole processing facility. In January 2016, WGS showed that the Listeria
isolate from the packaged salad was highly related genetically to isolates from
ill people.

This information linked the illnesses to Dole brand packaged salads
produced at the Dole processing facility in Springfield, Ohio.

On
January 21, 2016, Dole reported to CDC that it
had stopped production at the processing facility in Springfield, Ohio. The
company also reported that it is withdrawing packaged salads currently on the
market that were produced at this facility. The withdrawal does not affect
other Dole products.

CDC
recommends that consumers do not eat, restaurants do not serve, and retailers
do not sell packaged salads produced at the Dole processing facility in
Springfield, Ohio. These packaged salads were sold under various brand names,
including Dole, Fresh Selections, Simple Truth, Marketside, The Little Salad
Bar, and President's Choice Organics. The packaged salads can be identified by
the letter "A" at the beginning of the manufacturing code found on the
package. At this time, there is no evidence to suggest that packaged salads
produced at other Dole processing facilities in the United States are linked to
illness.

CDC
and state and local public health partners are continuing laboratory
surveillance through PulseNet to identify additional ill people and to
interview them.Updates
will be provided when more information is available.

martes, 5 de enero de 2016

Listeriosis patient isolates in Germany have shown a new
identical pulsed-field gel electrophoresis (PFGE) pattern since 2012 (n = 66).
Almost all isolates (Listeria monocytogenes serotype 1/2a) belonged to
cases living in southern Germany, indicating an outbreak with a so far unknown
source.

Case numbers in 2015 are high (n = 28). No outbreak cases outside
Germany have been reported.

Next generation sequencing revealed the unique
cluster type CT1248 and confirmed the outbreak.

Investigations into the source are ongoing. Since
November 2012, a previously not observed pulsed-field gel electrophoresis
(PFGE) pattern in human isolates of invasive L. monocytogenes serotype1/2a
has been detected in Germany with increasing frequency. Altogether 66 outbreak
cases have been recorded, with 28 cases in 2015. Four cases were pregnancy-associated
and six cases died in the course of the disease. Here we provide details of the
ongoing outbreak.

Outbreak description: Since 2009, all
German Listeria isolates submitted to
the National Reference Centre (NRC) for Salmonella and other bacterial enterics
at the Robert-Koch Institute (RKI) or to the Austrian-German binational
reference laboratory (KL) for Listeria at the Austrian Agency for Health and
Food Safety (AGES), have been tested with PFGE for clonal relationship.
Submission of isolates is encouraged by public health authorities but is voluntary
without legal obligation.

Between November 2012 and November 2015, altogether
793 isolates from notified listeriosis cases were typed, which accounted for 45%
of all cases in that period (n=1,765). In southern Germany, this proportion was
higher (ca 60%) and since 2012, human isolates of L. monocytogenes serotype 1/2a with the NRC internal nomenclature
of the AscI/Apa I pattern 13a/54 have been observed.

Regarding
the source of the causative food vehicle, the results showed a heterogeneous
picture. Until now, we have not observed cases with an epidemiological link to
an institution (e.g. hospital infection). Preliminary results largely exclude
fish and cheese products as a possible source but this has to be complemented
by systematic screening of Listeria isolates
collected from food. Based on sequencing results, a PCR protocol aiming to
detect CT1248 was developed for screening of isolates and published on the KL
website.